In my world, the world of functional medicine, we need to examine 2 issues before we get into healing the plantar fascia. Number one is we must look at the patient’s BIOMECHANICS, i.e., the structural and functional contributions to the problem. This may be congenital structural issues or problems with the functional aspects of walking and running. It can be poor training, over-training, tight muscles due to lack of stretching, improper footgear for that particular patient’s needs or the necessity to manage these issues with a prescribed, custom molded orthotic device.
- Poor nutrition/food quality
- Lack of adequate hydration
- Adrenal stress/Neurotransmitter imbalances
- Detoxification disorders
- Hormonal changes
In addition, we must look at what is involved in healing. The plantar fascia, being a connective tissue, receives its blood flow through microscopic blood vessels, not large arteries. In our modern society, we are dealing with many chronic stressors that can lead to adrenal/neurotransmitter imbalance. If there is an excitatory neurotransmitter dominance, we see microscopic blood vessels go into spasm. This is a primitive survival mechanism designed to shunt blood from the extremities and send it to the heart for increased blood flow to the upper arms and legs to either fight the beast that wants to eat us or run away from it. Correcting these chemical imbalances can alter the rate of perfusion into these tiny vessels in order to deliver the necessary substrates of healing.
To that end, I use homeopathic injections, prolotherapy, PRP or amniotic allograft injections. There are different reasons why I choose different approaches but it is all patient-specific. Regardless of the chosen therapy, they are all designed to get the immune activity focused on healing and repair and not on protection. In this way we heal patients AND we leave then healthier than when they first came to see us.
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